Atrovent is a nebuliser version of Spiriva rais..
There seems to have been a sea change in medical thinking over the last few years that nebulisers are not the way forward with treatment for lung disease and that regular inhalers should always be the preferred option for treatment.
Hence it's nigh on impossible nowadays to get a nebuliser on the NHS.
I was given mine by the respiratory sister at my local hospital a few years ago when I was going through a particularly bad time with my breathing and since the machine was not part of my GPs budget practise they will supply either Atrovent or Spiriva but always advise on Spiriva due to the escape of unused Atrovent from your nebuliser into the atmosphere.
The Spiriva takes 30 secs to administer whilst Atrovent probably takes 20 to 30 mins.
My rule of thumb is that if I am feeling quite groggy and listless I will sit and let my body "warm up" whilst I use the nebs otherwise it's a sharp intake of breath with the inhaler and get up and running.
Normally it's Spiriva.
Hope this is not conflicting advice.
Everyone have a good day!